Introduction: Habits and risk behaviors related to health have been responsible for changing the profile of morbidity and mortality in recent decades. Future health professionals, who should tackle and alleviate these problems, are studying in higher education about the importance of adopting a healthy lifestyle, but that is not guarantee that their habits are consistent with the theoretical background they hold. The aim of this study was to verify the presence of risk behaviors to health such as physical inactivity, poor nutrition, overweight / obesity, alcohol consumption and tobacco use among students of 1st and last period of different courses in the health of the Federal University of Sergipe. Methods: A descriptive comparative cross-sectional study with 238 students in the 1st period and 149 students in the last period of the courses of Medicine, Nursing, Dentistry and Physical Education of the Federal University of Sergipe, evaluating food consumption, physical activity level, alcohol consumption and smoke through a validated questionnaire, and level of obesity by calculating body mass index and fat percentage. Results: The students ate at a weekly frequency 1-3 days a week both healthy foods, such as milk, meat, fruits and vegetables, as unhealthy foods, such as soft drinks, sweets, snacks and fried foods. There was a small occurrence of smokers, but 67% of students in the final period began this habit after start their course. There were regular alcohol consumption in all courses, the Physical Education showed the highest occurrence, and 35% of students in the final period began drinking regularly after start their course. There were high rates of inactivity among students of all health courses. Analyzing the body mass index there was occurrence of overweight and obesity, reaching 37% in the last period of Medicine, and comparing students of 1st and last period in almost every course there was an increased of obesity, except Dentistry. The fat percentage data indicate a high occurrence of obesity in men. Conclusion: Although the sample was composed of students in the health area, which in principle have a better knowledge about healthy lifestyle practices, was verified the presence of risk behaviors in their daily habits. Therefore, it is necessary to rethink the relationship between theoretical knowledge and real change in lifestyle of an individual, and do more research to better targeting of strategies for health promotion, based on the regular practice of exercise and changes in food. / Introdução: Hábitos e comportamentos de risco relacionados à saúde têm sido responsáveis por alterações do perfil de morbi-mortalidade das últimas décadas. Futuros profissionais da área da saúde, que deverão combater e amenizar esses problemas, estudam no ensino superior sobre a importância da adoção de um estilo de vida saudável, mas isso não é garantia de que os mesmos possuam hábitos que condigam com o fundamento teórico que detêm. O objetivo desse estudo foi verificar a presença de comportamentos de risco à saúde, como sedentarismo, alimentação inadequada, sobrepeso/obesidade, consumo de álcool e tabaco, entre universitários do 1º e último períodos de diferentes cursos da área da saúde da Universidade Federal de Sergipe. Métodos: Estudo descritivo comparativo, transversal, realizado com 238 alunos do 1º período e 149 alunos do último período dos cursos de Medicina, Enfermagem, Odontologia e Educação Física da Universidade Federal de Sergipe, avaliando-se consumo alimentar, nível de atividade física, consumo de álcool e fumo por meio de um questionário validado, e nível de obesidade pelo cálculo do Índice de Massa Corporal e do percentual de gordura. Resultados: Os universitários consumiam numa freqüência semanal de 1 a 3 dias por semana tanto alimentos saudáveis, como leite, carne, frutas e verduras, quanto alimentos não-saudáveis, como refrigerantes, doces, salgados e frituras. Houve uma pequena ocorrência de fumantes, porém 67 % dos alunos do último período iniciaram esse hábito após o início do curso. Houve consumo regular de álcool em todos os cursos, sendo que Educação Física foi o que apresentou maior ocorrência, e 35% dos alunos do último período desse curso começaram a beber regularmente após o início do curso. Observaram-se altos índices de sedentarismo nos alunos de todos os cursos estudados. Analisando o Índice de Massa Corporal foi verificada a ocorrência de sobrepeso/obesidade, chegando até 37% no último período de Medicina, e quando comparados os alunos do 1° e último período em quase todos os cursos houve um aumento na ocorrência da obesidade, exceto Odontologia. Analisando o percentual de gordura os dados indicam uma alta ocorrência da obesidade nos homens. Conclusão: Embora a amostra tenha sido composta por estudantes da área da saúde, que, em princípio, são possuidores de maior conhecimento sobre práticas de vida saudáveis, verificou-se a presença de comportamentos de risco em seus hábitos diários. Assim, faz-se necessário repensar a associação entre o conhecimento teórico e a mudança real no estilo de vida de um indivíduo, e realizar mais pesquisas para um melhor direcionamento de estratégias para a promoção da saúde, baseados na prática regular de exercício físico e alterações na alimentação.

Objetivo: Avaliar a influência de sintomas de ansiedade e depressão, nível de estresse, consumo de álcool e drogas e repertório de habilidades sociais na prática de sexo sem preservativo em uma amostra representativa de indivíduos com HIV/AIDS em tratamento ambulatorial na cidade de São Paulo. Métodos: Participaram da pesquisa 667 pacientes, 383 (57,4%) homens e 284 (42,6%) mulheres, portadores do vírus HIV em tratamento na Casa da AIDS, Emílio Ribas, CRT Santa Cruz, SAE DST/AIDS Campos Elíseos, SAE DST/AIDS Cidade Líder II, CR DST/AIDS Nossa Senhora do Ó, AE Vila Prudente e CR DST/AIDS Santo Amaro. Para a coleta de dados foram utilizados os seguintes instrumentos: Mini Exame do Estado Mental, questionário sociodemográfico, Escalas de Avaliação de Ansiedade e Depressão de Beck, Inventário de Sintomas de Estresse, Escala de assertividade de Rathus, questionário sobre uso de álcool, tabaco e outras drogas, AUDIT, Questionário sobre Comportamento Sexual na Vida e a Escala de Avaliação de Comportamento Sexual de Risco - SERBAS. Os pacientes foram entrevistados nos locais onde faziam seu tratamento. Resultados: A análise múltipla mostrou que ter algum parceiro soropositivo e ter feito uso de maconha antes do sexo foram associados negativamente ao uso do preservativo. Ter dois ou mais parceiros sexuais nos últimos três meses foi associado a ter trabalho regular, ter feito sexo em grupo, contaminação anterior por alguma outra doença sexualmente transmissível, parceiro soropositivo, não residir com o parceiro, sexo em troca de álcool, droga, abrigo/comida alguma vez na vida, orientação homossexual, prática de sexo anal, CD4 acima de 350 cels/mm3 e uso de cocaína antes do sexo. Sintomas de ansiedade e depressão, nível de estresse e falta de habilidades sociais afetaram significativamente a vida sexual dessa população diminuindo as chances de fazer sexo nos três meses anteriores à entrevista, mas não mostraram associação com o uso de preservativo e múltiplos parceiros. Conclusão: Pessoas com HIV que fazem sexo sem preservativo apresentam características diferentes daquelas que tem múltiplos parceiros. A sorologia do parceiro foi uma variável importante para a prática de sexo sem preservativo. A orientação homo e bissexual, prática de sexo anal e o sexo masculino foram mais associadas a ter mais parceiros sexuais. O consumo de álcool e outras drogas esteve presente nos dois comportamentos de risco. Identificar os fatores associados a esses comportamentos de risco e as diferenças encontradas no perfil das pessoas que fizeram sexo sem preservativo e daquelas que tiveram múltiplos parceiros são pontos importantes para programas de prevenção. Tais características podem servir como marcadores que auxiliam os profissionais de saúde a detectar possíveis comportamentos de risco e planejar estratégias de prevenção / Introduction: The AIDS epidemic is a major public health problem. It is estimated that, even after becoming aware of their serostatus, one in three people with HIV continues to have sex without a condom, regardless of the partner\'s serostatus. Purpose: To evaluated the influence of symptoms of anxiety and depression, stress level, alcohol and drug use and the range of social skills on having sex without a condom in a representative sample of individuals living with HIV/AIDS and receiving outpatient treatment in the city of São Paulo. Methods: 667 patients - 383 (57.4%) men and 284 (42.6%) women - with HIV and being treated at Casa da AIDS, Emílio Ribas, CRT Santa Cruz, SAE DST/AIDS Campos Elíseos, SAE DST/AIDS Cidade Líder II, CR DST/AIDS Nossa Senhora do Ó, AE Vila Prudente and CR DST/AIDS Santo Amaro participated in the study. The following tools were used to collect data: Mini-Mental State Examination, social and demographic survey, Beck Anxiety and Depression Inventories, Stress Symptom Inventory, Rathus Assertiveness Schedule, alcohol, tobacco and other drugs use survey, Alcohol Use Disorders Identification Test (AUDIT), Sexual Behavior Survey, and Sexual Risk Behavior Assessment (SERBAS). Patients were interviewed at the places where they were being treated. Results: The multiple analysis has shown that having an HIV-positive partner and using marijuana before sex were negatively associated with condom use. Having two or more partners over the past three months was been associated with having regular job, have done group sex, previous infection with other sexually transmitted infections, an HIV-positive partner, not living with the partner, sex in exchange for alcohol, drug, shelter/food at least once in their lives, homosexuality, engagement in anal sex, CD4 cells/mm3 count above 350, and use of cocaine before sex. Anxiety and depression symptoms, stress level and lack of social skills significantly affected the sexual lives of that population, making them less likely to have sex in the three months before the interview, but they were not associated with the use of a condom and multiple partners. Conclusion: The characteristics of HIV-positive individuals who have unprotected sex are different from those who have multiple partners. The partners\' serostatus was an important variable for engaging in unprotected sex. Homosexuality and bisexuality, anal sex and male gender were more associated in individuals who had more sexual partners. Use of alcohol and other drugs was present in both risk behaviors. Identifying the factors associated with those risk behaviors and the differences between the profiles of the individuals who had sex without a condom and those who had multiple partners is critical for prevention programs. Such characteristics can serve as markers to help health care professionals identify possible risk behaviors and plan prevention strategies ____________________________

Utilizou-se de um inquérito domiciliar de saúde, realizado em dois distritos administrativos de São Paulo (compreendendo uma população de 190 mil habitantes) em 2001, para se analisar o possível impacto do \"Programa de Saúde da Família\" (PSF) - QUALIS na morbidade referida e estilo de vida dos maiores de 14 anos. Utilizando-se de análise uni e multivariada, com diversas variáveis sócio-econômicas, mostrou-se que há diferenças na morbidade crônica entre as populações cobertas ou não pelo PSF. Esse fato deve-se, possivelmente, a um maior acesso à Atenção Primária por parte das populações cobertas por essa nova estratégia. Praticamente não houve diferenças em relação a estilo de vida. / A health survey, held in 2001 in two administrative districts of the city of Sao Paulo (inhabited by 190,000 people) was used to measure the impact of the \"Family Health Program\" - QUALIS in referred morbidity and lifestyle for those 15 and older. Through univariate and multivariate analysis, using several socioeconomic measures, we came to the conclusion that there are differences in chronicle morbidity between the populations attended or not by the program. It is so, possibly, due to a larger access to Primary Health System with this new strategy. There is basically no difference concerning lifestyle.

Abstract Traumatic brain injury can be a catastrophe for an individual and a huge economic burden for a society. Such injuries are common especially among young men and as many as half of the patients are under the influence of alcohol at the time of injury. Traumatic brain injuries can also frequently cause epileptic seizures. On the other hand, epileptic seizures are often caused by alcohol. A significant reduction in the tax on alcohol in Finland in 2004 led to a 10% increase in its consumption at the population level and a considerable increase in mortality rate among patients with alcoholic liver diseases. The risk of subsequent epileptic seizures and traumatic brain injuries among intoxicated head trauma subjects has not been evaluated before. The present cohort consists of all subjects who were admitted to the emergency room at Oulu University Hospital in 1999 on account of head trauma. These subjects were then followed-up for 10 years, which enabled the effect of the tax reduction on the long-term outcome to be observed. The effect of being under the influence of alcohol at the time of the index head trauma on the onset of a new epileptic seizure problem and further traumatic brain injuries was investigated. The mortality rate among head trauma subjects with harmful drinking increased significantly after the reduction in the alcohol tax, and the subjects with recorded alcohol-related seizure problems experienced an increased risk of death after the price reduction. Head trauma under the influence of alcohol predicted both new-onset seizure problems and traumatic brain injury during the follow-up. The results are in accordance with the previous observations of a rapid increase in mortality among heavy drinkers following a sharp reduction in alcohol prices. Inebriated head trauma subjects have an increased risk of subsequent traumatic brain injury and epileptic seizure. / Tiivistelmä Traumaattinen aivovamma voi olla potilaalle katastrofi ja yhteiskunnalle valtava taloudellinen tappio. Aivovammat ovat yleisiä erityisesti nuorilla miehillä, ja jopa puolet niistä tapahtuu alkoholin vaikutuksen alaisena. Aivovammat aiheuttavat usein epileptisiä kohtauksia, jotka toisaalta usein johtuvat alkoholista. Vuonna 2004 Suomessa tapahtunut mittava alkoholiveron alennus lisäsi väestötasolla alkoholin kokonaiskulutusta 10 % vuoden aikana. Kuolleisuus erityisesti alkoholimaksasairauksiin lisääntyi voimakkaasti. Aiemmin ei ole tiedetty humalassa ilmaantuneen pään vamman vaikutuksesta potilaan riskiin saada uusi aivovamma tai uusi epileptinen kohtaus. Tutkimuskohortin muodostivat vuonna 1999 Oulun yliopistollisen sairaalan päivystyksessä hoidetut päähän vammautuneet potilaat. Heitä seurattiin rekisteritietojen avulla vuoden 2009 loppuun, minkä ansiosta voitiin tutkia veronalennuksen vaikutusta potilaiden pitkäaikaisennusteeseen. Tutkimuksessa havainnoitiin humalassa tapahtuneen pään vamman vaikutusta epileptisen kohtauksen ja uuden aivovamman ilmaantumiseen seuranta-aikana. Haitallisesti alkoholia käyttävien päähän vammautuneiden potilaiden kuolleisuus lisääntyi merkitsevästi alkoholiveron alennuksen jälkeen. Myös alkoholiin liittyvän epileptisen kouristuksen sairastaneilla kuolleisuus lisääntyi merkitsevästi. Alkoholin vaikutuksen alaisena tapahtunut pään vamma oli riskitekijä uudelle epileptiselle kohtaukselle sekä uudelle aivovammalle seuranta-aikana. Tulokset vahvistavat aiempia havaintoja siitä, että alkoholin hinnan voimakas lasku lisää nopeasti alkoholin suurkuluttajien kuolleisuutta. Humalassa päätään loukanneella on lisääntynyt riski saada uusi aivovamma sekä uusi epileptinen kohtaus.

<p>Oralni karcinom je po učestalosti &scaron;esta najče&scaron;ća maligna bolest u svetu čija incidenca varira u različitim geografskim područjima. Predstavlja 5% svih novootkrivenih malignih tumora godi&scaron;nje i čini 14% svih malignih tumora glave i vrata. Pod oralnim karcinom podrazumevamo planocelularni karcinom obzirom na činjenicu da on čini preko 90% malignih tumora oralne lokalizacije, dok se u manjem procentu javljaju drugi tumori (maligni tumori malih pljuvačnih žlezda, limfomi, mezenhimni tumori). Oralni karcinom podrazumeva karcinome koji se javljaju u sledećim anatomskim regijama: sluznici prednje 2/3 jezika, poda usta, obraza, gingivi gornje i donje vilice, retromolarnom trouglu, kao i sluznici mekog i tvrdog nepca. Najče&scaron;ća lokalizacija oralnog planocelularnog karcinoma je sluznica pokretnog dela jezika i poda usta. Oralni karcinom se če&scaron;će javlja kod mu&scaron;karaca (odnos mu&scaron;karci:žene je 3:1) verovatno zbog većeg procenta rizičnog pona&scaron;anja kod mu&scaron;karaca. Najče&scaron;će se javlja u &scaron;estoj i sedmoj deceniji života (medijana je 62 godine) iako se poslednjih godina sve če&scaron;će javlja kod mlađih od 45 godina. Faktori rizika za oboljevanje su dobro poznati. Na prvom mestu se izdvaja pu&scaron;enje duvana (značajna je dužina pu&scaron;enja, da li pacijent pu&scaron;i lulu ili cigaretu, da li žvaće duvan, kao i dužina trajanja apstinencije). Smatra se da je smrtnost kod oralnog karcinoma direktno povezana sa brojem popu&scaron;enih cigareta na dan. Preko 75% pacijenata sa oralnim karcinomom anamnestički daje podatak o prekomernoj upotrebi alkohola. Postoji sinergističko dejstvo alkohola i cigareta, dugotrajna ekspozicija ovim faktorima rizika dovodi do pojave &ldquo;polja kancerizacije&ldquo;, pojave genetske nestabilnosti i razvoja tumora. Kod oralnog planocelulranog karcinoma primećene su hromozomske abnormalnosti koje su rezultat o&scaron;tećenja DNK i uključuju promene genetskog materijala na hromozomima.Jedna od najče&scaron;ćih genetskih abnormalnosti kod oralnog planocelularnog karcinoma je mutacija r53 gena koji se nalazi na kratkom kraku hromozoma 17 i predstavlja tumor supresor gen. Planocelularni karcinom nije te&scaron;ko dijagnostikovati kada postane simptomatski. Pacijent se žali na bol, krvavljenje, otalgiju, otežano gutanje, smanjenje pokretljivosti jezika. Neretko je prvi simptom metastatski uvećan limfni čvor na vratu jer bolesnici ne primećuju ili ignori&scaron;u oralnu patologiju. Dijagnoza oralnog karcinoma se postavlja na osnovu detaljno uzete anamneze, kliničkog pregleda i patohistolo&scaron;ke verifikacije. Oralni planocelularni karcinom se javlja u tri klinike forme: egzofitična, endofitična i infiltrativna. Zlatni standard za dijagnozu oralnog karcinoma je biopsija i patohistolo&scaron;ka verifikacija, pri čemu se može primeniti &bdquo;punch&ldquo; biopsija, inciziona biopsija ili eksciziona biopsija kod manjih promena. TNM &bdquo;staging&ldquo; sistem AJCC (American Joint Committee on Cancer) se danas standardno koristi za klinički &bdquo;staging&ldquo; oralnog karcinoma i bazira se na podacima dobijenim kliničkim pregledom i &bdquo;imaging&ldquo; metodama. Sam &bdquo;staging&ldquo; je bitan kako zbog komunikacije među lekarima koji učestvuju u lečenju bolesnika tako i zbog standardizacije prognoze. T stadijum označava veličinu primarnog tumora, N stadijum označava regionalnu nodalnu zahvaćenost dok M stadijum prikazuje prisustvo udaljenih metastaza. Terapija patohistolo&scaron;ki dokazanog oralnog karcinoma zahteva multidisciplinarni pristup. Osnova terapije oralnog planocelularnog karcinoma je hirur&scaron;ko lečenje koje podrazumeva ablativno i rekonstruktivno hirur&scaron;ko lečenje. Osnovni princip ablativne hirurgije kod oralnog karcinoma je resekcija primarnog tumora sa najmanje 1cm negativnim hirur&scaron;kim marginama. Pored ablacije tumora hirur&scaron;ko lečenje podrazumeva i uklanjanje regionalnih limfnih čvorova vrata. Cilj disekcije vrata je da se kod klinički evidentnih metastaza iste uklone (terapijska disekcija) ili da se uklone okultne metastaze koje su klinički neevidentne (elektivna disekcija). Oralni planocelularni karcinom spada u tumore sa visokom stopom smrtnosti, većom nego &scaron;to je kod limfoma, laringealnog karcinoma, karcinoma testisa i endokrinih karcinoma. Stopa petogodi&scaron;njeg preživljavanja je direktno povezana sa veličinom tumora, prisustvom metastaza u regionalnim limfnim čvorovima i prisutvom udaljenih metastaza. Prosečno trogodi&scaron;nje preživljavanje bolesnika sa oralnim karcinomom je 52% dok je prosečno petogodi&scaron;nje preživljavanje oko 39% i ove stope se nisu mnogo menjale tokom godina bez obzira na nova saznanja i nove pristupe lečenju oralnog planocelulanog karcinoma. Ciljevi istraživanja su da se utvrdi da li postoji korelacija debljine OPK izmerene kompjuterizovanom tomografijom i svetlosnim mikroskopom, da li dubina invazije OPK i volume tumora mogu biti prediktivni faktor za razvoj regionalnih cervikalnih metastaza kod oralnog planocelularnog karcinoma. Istraživanje je uključilo 65 konsekutivnih bolesnika oba pola lečenih od oralnog karcinoma na Klinici za maksilofacijalnu hirurgiju Kliničkog centra Vojvodine. Dijagnoza oralnog karcinoma je postavljena na osnovu anamneze, kliničkog pregleda i biopsije. U sklopu TNM &bdquo;staging&ldquo;-a bolesnika načinjen je pregled glave i vrata i grudnog ko&scaron;a kompjuterizovanom tomografijom (CT) na osnovu kog smo dobili podatak o dimenzijama tumora. Na osnovu kliničkog nalaza i analize CT nalaza planiralo se operativno lečenje u skladu sa bolesnikovim TNM statusom. Postoperatativni patohisto&scaron;ki preparati je pregledan od strane istog patologa. Parametri koji će su određivani su sledeći: 1. Veličina tumora (2 dimenzije) izmerene na osnovu CT pregleda izražene u cm 2. Debljina tumora izmerena na osnovu CT pregleda izražena u cm 3. Veličina tumora (2 dijametra) na makroskopskom preparatu izražena u cm 4. Debljina tumora na mikroskopskom preparatu izmerena svetlosnim mikroskopom izražena u cm 5. Dubina invazije tumora na mikroskopskom preparatu izmerena svetlosnim mikroskopom izražena u mm 6. Volumen tumora koji se izračunavao prema formuli: VT=&pi;/6 x maksimalni dijametar tumora A x minimalni dijametar tumora B x dubina invazije tumora i izražava se u cm&sup3; 7. Broj metastatski izmenjenih limfnih čvorova u disekatu vrata 8. Ukupan broj patohistolo&scaron;ki ispitanih limfnih čvorova u disekatu vrata Nakon prikupljanja planiranog materijala urađena je statistička obrada podataka. Statistička analiza podataka je uključila metode deskriptivne statistike (srednja vrednost, standardna devijacija, učestalost), kao i standardne parametrijske i neparametrijske testove za komparacije dve grupe (Studentov T test, Mann&ndash;Whitney U test, hikvadrat test). U fazi statističke analize međusobnih uticaja i povezanosti prikupljenih podataka kori&scaron;ćen je Pearsonov test korelacije. Sva testiranja sprovedena su na nivou statističke značajnosti p&lt;0,05. REZULTATI: Istraživanje je obuhvatilo 65 bolesnika, od kojih je 82% bilo mu&scaron;kog pola prosečne starosti 59 godina. 83% bolesnika su se izja&scaron;njavali kao pu&scaron;ači, dok je 69% bolesnika navelo da redovno koristi alkohol. Svim pacijentima je tokom hirur&scaron;kog lečenja OPK rađena disekcija vrata i to najče&scaron;čće selektivna disekcija vrata (91%). Kod 30 bolesnika je utvrđeno postojanje cervikalnih regionalnih metastaza na operativnom preparatu te su bolesnici podeljeni u dve grupe: sa prisustvom i bez prisustva metastaza u limfnim čvorovima vrata. Utvrđeno je da se ove dve grupe statistički značajno razlikuju u dubini invazije tumora i volumenu tumora. Utvrđeno je takođe da postoji statistički značajna korelacija između debljine tumora izmerene CT pregledom i debljine tumora izmerene svetlosnim mikroskopom. Dokazano je da dubina invazije tumora veća od 7mm i zapremina tumora veća od 4cm&sup3; predstavljaju prediktivni faktor za pojavu regionalnih cervikalnih metastaza. ZAKLjUČAK: Na osnovu istraživanja izvedeni su zaključci koji ukazuju na to da postoji statistički značajna korelacija između debljine tumora OPK izmerene CTpregledom i svetlosnim mikroskopom te se debljina tumora izmerena CT pregledom može koristiti za planiranje operativnog zahvata prilikom lečenja OPK. Dubina invazije tumora veća od 7mm i volumen tumora veći od 4 cm&sup3; predstavljaju prediktivni faktor za pojavu nodalnih cervikalnih metastaza te su značajni za određivanje stadijuma bolesti.</p> / <p>Oral cancer is the sixth most common malignant disease in the world which incidence varies based on geographic area. It represents 5% of all newly discovered malignant tumors annually and constitutes 14 % of all malignant tumors of head and neck. Squamous cell carcinoma is considered to be a type of oral cancer because more than 90 % of malignant tumors that occur in oral cavity are squamous cell carcinomas while other tumors (malignant tumor of minor salivary gland, lymphoma, sarcoma) rarely occur. Oral cancer is the cancer found in the following anatomic regions: mucosa of front two-thirds of the tongue, the floor of the mouth, cheeks, upper and lower gingiva, retromolar trigone as well as&nbsp; mucosa of soft and hard palates. Oral squamous cell carcinoma is most commonly localized in mucous membrane of the movable part of the tongue and floor of the mouth. Men are more affected than women (male to female ratio is 3:1) probably because of men&rsquo;s riskier behavior. It is most commonly diagnosed in the sixth and seventh decade of life (the median is 62 years old) although it has been diagnosed in patents younger than 45 in recent years. Risk factors of oral squamous cell carcinoma are well known. The major factor is tobacco smoking (the period of smoking is significant, it is also important to consider whether a patient smokes a pipe or cigarette, whether he/she chews tobacco as well as the period of abstinence). The mortality rate is believed to be directly related to the number of cigarettes smoked a day. An excessive use of alcohol has been reported in over 75% of patients with oral cancer. There is a synergistic effect of alcohol and cigarette consumption and long-term exposure to these risk factors results in &lsquo;field of cancerization&rsquo;, genetic instability and tumor development. Chromosome abnormalities, which are caused by DNA damage and include the change in genetic material of chromosomes, have been reported in patients with oral squamous cell carcinoma. One of the most common genetic abnormalities in patients with oral squamous cell carcinoma is a mutation of р53 gene which is located on a short arm of chromosome 17 and represents a tumor suppressor gene. Oral squamous cell carcinoma is not difficult to diagnose when it becomes symptomatic. The patient complains of pain, bleeding, otalgia, swallowing difficulties, decreased tongue mobility. The first symptom is rarely metastatic lymph node on the neck because patients either do not notice or ignore oral pathology. The oral cancer is diagnosed based on the detailed anamnesis, physical examination and pathohistological verification. The oral squamous cell carcinoma occurs in three clinical forms: exophytic, endophytic and infiltrative form. The gold standard for diagnosis of oral cancer is biopsy and pathohistological verification. However, in case of smaller changes, punch biopsy, incisional and excisional biopsies can also be applied. ТNМ staging system of AJCC (American Joint Committee on Cancer) is nowadays used for clinical staging of oral cancer and it is based on the data acquired by clinical examination and imaging methods. Not only is the staging itself important for communication between the doctors involved in treatment, but it is also important for standardization of prognosis. Т describes the size of primary tumor, N describes regional nodal spread and М describes distant metastasis. The treatment of histopathologically proven oral cancer requires multidisciplinary approach. The main treatment of oral squamous cell carcinoma is surgical treatment which involves ablative and reconstructive surgical treatment. The basic principle of ablative surgery for oral cancer is the resection of primary tumor with at least 1 cm negative surgical margins. Apart from tumor ablation surgical treatment also involves removal of regional lymph nodes on the neck. The aim of neck dissection is to remove clinically evident metastasis (therapeutic dissection) or to remove occult metastasis that are not clinically evident (elective dissection). The oral squamous cell carcinoma is the cancer with high mortality rate. The mortality rate is higher than the mortality rate for lymphoma, laryngeal cancer, testicular cancer and endocrine cancer. The five-year survival rate is directly related to the size of the tumor, presence of metastasis in regional lymph nodes and distant metastasis. The average three-year survival rate of the patients with oral cancer is 52% and the average five-year survival rate is 39%. These rates have not changed a lot over the years regardless of new knowledge and approaches in treatment of oral squamous cell carcinoma. The aims of the study are to determine whether there is a correlation between the depth of invasion of oral squamous cell carcinoma determined by computed tomography and light microscope and whether the invasion depth of OSCC and tumor volume can be predictive factors of development of regional cervical metastases in case of oral squamous cell carcinoma. The study covered 65 consecutive patients of both sexes who received treatment for oral cancer at the Clinic for Maxillofacial Surgery of the Clinical Center of Vojvodina. The diagnosis of oral cancer was established based on the anamnesis, physical examination and biopsies. The TNM &lsquo;staging&rsquo; of the cancer involved the examination of the patient&rsquo;s head and thorax by computed tomography (CT) which enabled us to obtain reliable data about the tumor size. After obtaining clinical findings and CT results, the patients&rsquo; treatment was planned based on their TNM status. A postoperative histopathological examination was performed by the same pathologist and the following parameters were determined: 1. Tumor size (2 dimensions) measured by CT and expressed in cm 2. Tumor thickness measured by CT and expressed in cm 3. Tumor size (2 diameters) on microscopic device and expressed in cm 4. Tumor thickness on microscopic device measured by light microscope and expressed in cm 5. Depth of tumor invasion on microscopic device measured by light microscope and expressed in cm 6. Tumor volume calculated based on the following formula: VT=&pi;/6 x maximum tumor diameter А x minimum tumor diameter B x depth of tumor invasion and expressed in cm&sup3; 7. The number of metastatic lymph nodes in the neck dissection 8. Total number of pathohistologically tested lymph nodes in the neck dissection. Upon collecting the planned material, statistical analysis of all data was carried out. The statistical analysis included the methods of descriptive statistics (mean value, standard deviation, frequency) and standard parametric and nonparametric tests for comparison of two groups (Student&rsquo;s T test, Whitney U test, chi-square test). The Pearson&rsquo;s Test of Correlation was used in the phase of statistical analysis of interaction effects and correlation of obtained data. All tests were performed at the level of statistical significance of p&lt;0.05. RESULTS: The study covered 65 patients, out of which 82% were male patients aged 59. 83% of patients said they smoked and 69% of patients stated that they consumed alcohol regularly. A neck dissection was performed in all patients during surgical treatment of OSCC and it was selective neck dissection (91%). Cervical regional metastasis was found in 30 patients so they were divided into two groups: the group of patients who had metastasis in the lymph nodes and the group of patients with no metastasis in lymph nodes of the neck. It was determined that there was a statistically significant difference in depth of invasion and tumor volume between these two groups. The statistically significant difference was also determined between the thickness of tumor measured by CT and thickness of tumor measured by light microscope. Moreover, the depth of invasion of tumor greater than 7mm and volume of tumor greater than 4cm&sup3; were proven to represent a predictive factor of development of regional cervical metastasis. The study results show that there is a statistically significant correlation between the thickness of OSCC tumor measured by CT and the thickness measured by light microscope, so the thickness of tumor measured by CT can be used for planning the surgery during the treatment of OSCC. The depth of tumor invasion greater than 7 mm and tumor volume greater than 4 cm&sup3; represent a predictive factor of development of cervical metastasis, which means that they are significant for determining the stage of disease.</p>

Background: Alcohol consumption has been causally related to the incidence of coronary heart disease, but the role of alcohol before the event has not been explored in depth. This study tested the hypothesis that heavy drinking (binge drinking) increases the risk of subsequent acute myocardial infarctions (AMI), whereas light to moderate drinking occasions decrease the risk. Methods: Case-crossover design of 250 incident AMI cases in Switzerland, with main hypotheses tested by conditional logistic regression. Results: Alcohol consumption 12 h before the event significantly increased the risk of AMI (OR 3.1; 95% CI 1.4–6.9). Separately, the effects of moderate and binge drinking before the event on AMI were of similar size but did not reach significance. In addition, AMI patients showed more binge drinking than comparable control subjects from the Swiss general population. Conclusions: We found no evidence that alcohol consumption before the event had protective effects on AMI. Instead, alcohol consumption increased the risk. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

O presente estudo se propõe a Identificar o número de Instituições de Ensino Superior (IES) que desenvolvem programas relacionados ao tema drogas nas áreas de ensino, prevenção e assistência e descrever o perfil de seus programas, além de conhecer como os alunos percebem a existência de ações de apoio à saúde, informações e ajuda sobre o consumo de drogas. Participaram do estudo 100 Instituições de Ensino Superior, localizadas nas 27 capitais dos estados brasileiros. Os alunos foram selecionados por sorteio sistemático das classes em cada instituição. Como instrumentos de coleta de dados foram utilizados: pesquisa aos sites institucionais, questionário estruturado respondido pelos alunos, questionário semiestruturado respondido pela instituição e analise qualitativa pela técnica de análise de conteúdo dos programas. Apesar da maioria dos estudantes saber da existência de serviços atendimento de saúde direcionados aos alunos, poucos utilizam o serviço, enquanto 71% dos alunos referem não ter recebido informações referentes ao uso de drogas e seu impacto na saúde em sua escola, no último ano. Das 100 IES, 82 instituições responderam ao questionário e destas, 32,9% (27 instituições) informam a existência de programas de prevenção, assistência ou orientação ao uso de álcool, tabaco ou outras drogas. Dos 27 programas, 51,9% fazem parte do projeto pedagógico institucional. As ações incluem prevenção 81,5% (22 em 27) associada a atividades de orientação (44,4%) e/ou assistência (48,1%). Os núcleos de apoio psicopedagógico existem em mais de metade nas instituições que têm programas relacionados ao uso de drogas. Foram analisados 18 programas, todos atuam na área da prevenção, mas são muito diversificados em abrangência, população alvo e atividades planejadas. Conclusões: No Brasil não é uma exigência legal a existência de projetos que tenham esse foco. A porcentagem de escolas com programas é pequena e deve ser estimulada a criação de programação de orientação para álcool, tabaco e outras drogas. Uma avaliação sistematizada interna e externa dos programas é necessária para identificar resultados efetivos, e para isso devem atuar em múltiplas frentes com uma participação ampliada do corpo diretivo, estudantes, docentes, funcionários e membros da comunidade. Além de fornecer informações, os programas devem ter por objetivo contribuir para mudar as atitudes e comportamentos / This study\'s proposal is to identify the number of Higher Education Institutions (IES - Instituições de Ensino Superior) that develop programs related to the topic drugs in the areas of teaching, prevention and assistance, describe the profile of said programs, as well as learn how the students perceive the existence of initiatives on improving health, and providing information and support related to the consumption of drugs. 100 Higher Education Institutions participated on the study, 27 located in the capitals of the Brazilian states. The participating students classes were randomly chosen through computer-aided randomization in each institution. The utilized instruments for the collecting data were: searches on the institution websites, semi structured survey answered by the students, semi structured survey answered by the institution, and the qualitative analysis through the technique of program content analysis. Although most students knew about the existence of healthcare services directed to students, few utilized the service, while 71% of the students report for the last year not having received in their schools, information related to the usage of drugs and it\'s impact on health. Of the 100 IES, 82 institutions answered the survey and of those, 32,9% (27 institutions) informed the existence of programs for prevention, assistance or guidance regarding the usage of alcohol, tobacco or other drugs. Of the 27 programs, 51,9% are part of the institutional pedagogical Project. The initiatives include prevention 81,5% (22 out of 27), related to guidance activities (44,4% and/or assistance (48,1%). The psycho pedagogic support groups exist in more than half institutions that have programs related to the usage of drugs. 18 programs were analyzed, all acting in prevention, but very distinct in range, target population and planned activities. Conclusions: Brazil does not have a legal requirement of the existence of projects with this focus. The percentage of schools with programs is small and the creation of programs of guidance on alcohol, tobacco and other drugs must be stimulated. A systematic evaluation of the internal and external programs is needed to identify effective results, and for that this evaluation must act on multiple fronts with an extended participation of the directive body, students, teachers, employees and community members. Besides supplying information, the programs must have an objective of contributing to the changing of attitudes and behaviors

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

O presente estudo se propõe a Identificar o número de Instituições de Ensino Superior (IES) que desenvolvem programas relacionados ao tema drogas nas áreas de ensino, prevenção e assistência e descrever o perfil de seus programas, além de conhecer como os alunos percebem a existência de ações de apoio à saúde, informações e ajuda sobre o consumo de drogas. Participaram do estudo 100 Instituições de Ensino Superior, localizadas nas 27 capitais dos estados brasileiros. Os alunos foram selecionados por sorteio sistemático das classes em cada instituição. Como instrumentos de coleta de dados foram utilizados: pesquisa aos sites institucionais, questionário estruturado respondido pelos alunos, questionário semiestruturado respondido pela instituição e analise qualitativa pela técnica de análise de conteúdo dos programas. Apesar da maioria dos estudantes saber da existência de serviços atendimento de saúde direcionados aos alunos, poucos utilizam o serviço, enquanto 71% dos alunos referem não ter recebido informações referentes ao uso de drogas e seu impacto na saúde em sua escola, no último ano. Das 100 IES, 82 instituições responderam ao questionário e destas, 32,9% (27 instituições) informam a existência de programas de prevenção, assistência ou orientação ao uso de álcool, tabaco ou outras drogas. Dos 27 programas, 51,9% fazem parte do projeto pedagógico institucional. As ações incluem prevenção 81,5% (22 em 27) associada a atividades de orientação (44,4%) e/ou assistência (48,1%). Os núcleos de apoio psicopedagógico existem em mais de metade nas instituições que têm programas relacionados ao uso de drogas. Foram analisados 18 programas, todos atuam na área da prevenção, mas são muito diversificados em abrangência, população alvo e atividades planejadas. Conclusões: No Brasil não é uma exigência legal a existência de projetos que tenham esse foco. A porcentagem de escolas com programas é pequena e deve ser estimulada a criação de programação de orientação para álcool, tabaco e outras drogas. Uma avaliação sistematizada interna e externa dos programas é necessária para identificar resultados efetivos, e para isso devem atuar em múltiplas frentes com uma participação ampliada do corpo diretivo, estudantes, docentes, funcionários e membros da comunidade. Além de fornecer informações, os programas devem ter por objetivo contribuir para mudar as atitudes e comportamentos / This study\'s proposal is to identify the number of Higher Education Institutions (IES - Instituições de Ensino Superior) that develop programs related to the topic drugs in the areas of teaching, prevention and assistance, describe the profile of said programs, as well as learn how the students perceive the existence of initiatives on improving health, and providing information and support related to the consumption of drugs. 100 Higher Education Institutions participated on the study, 27 located in the capitals of the Brazilian states. The participating students classes were randomly chosen through computer-aided randomization in each institution. The utilized instruments for the collecting data were: searches on the institution websites, semi structured survey answered by the students, semi structured survey answered by the institution, and the qualitative analysis through the technique of program content analysis. Although most students knew about the existence of healthcare services directed to students, few utilized the service, while 71% of the students report for the last year not having received in their schools, information related to the usage of drugs and it\'s impact on health. Of the 100 IES, 82 institutions answered the survey and of those, 32,9% (27 institutions) informed the existence of programs for prevention, assistance or guidance regarding the usage of alcohol, tobacco or other drugs. Of the 27 programs, 51,9% are part of the institutional pedagogical Project. The initiatives include prevention 81,5% (22 out of 27), related to guidance activities (44,4% and/or assistance (48,1%). The psycho pedagogic support groups exist in more than half institutions that have programs related to the usage of drugs. 18 programs were analyzed, all acting in prevention, but very distinct in range, target population and planned activities. Conclusions: Brazil does not have a legal requirement of the existence of projects with this focus. The percentage of schools with programs is small and the creation of programs of guidance on alcohol, tobacco and other drugs must be stimulated. A systematic evaluation of the internal and external programs is needed to identify effective results, and for that this evaluation must act on multiple fronts with an extended participation of the directive body, students, teachers, employees and community members. Besides supplying information, the programs must have an objective of contributing to the changing of attitudes and behaviors